|Publication number||US7467017 B2|
|Application number||US 11/103,001|
|Publication date||Dec 16, 2008|
|Filing date||Apr 11, 2005|
|Priority date||Apr 12, 2004|
|Also published as||US20050228470|
|Publication number||103001, 11103001, US 7467017 B2, US 7467017B2, US-B2-7467017, US7467017 B2, US7467017B2|
|Inventors||Thomas P. Osypka|
|Original Assignee||Oscor, Inc.|
|Export Citation||BiBTeX, EndNote, RefMan|
|Patent Citations (7), Referenced by (1), Classifications (8), Legal Events (3)|
|External Links: USPTO, USPTO Assignment, Espacenet|
The subject application claims the benefit of priority from U.S. Provisional Patent Application Ser. No. 60/561,451, filed Apr. 12, 2004, the disclosure of which is herein incorporated by reference in its entirety.
1. Field of the Invention
The subject invention is directed to cardiac leads, and more particularly, to an implantable defibrillation lead that includes one or more articulated shocking coils for delivering electrical energy to cardiac tissue.
2. Background of the Related Art
An implantable cardioverter defibrillator (ICD) is a device that is implanted in the chest to monitor for and, if necessary, correct episodes of certain types of abnormal heart rhythms (arrhythmia). One example of such an arrhythmia is an exceptionally fast heartbeat (ventricular tachycardia), in response to which an ICD will supply a small amount of electrical energy to stimulate the heart and restore a normal rhythm (i.e., the ICD performs “anti-tachycardia pacing”). This act of converting one heart rhythm to another is called “cardioversion”. In more extreme cases, the heartbeat may be so rapid that it amounts to quivering rather than beating; this is called “ventricular fibrillation.” To remedy this potentially fatal condition, an ICD performs “defibrillation” by administering a relatively large amount of electrical energy to the heart to restore a normal heartbeat.
In order to perform the above functions, the ICD includes an electrical signal generator and an implantable defibrillation lead for operatively connecting the generator to the heart. The signal generator is contained within a housing that is implanted in the chest of a patient during a surgical procedure. The implantable defibrillation lead is passed through a blood vessel until the distal end of the lead engages the inner surface of the heart. The other (proximal) end connects to the signal generator. In general, these leads include one or more elongated shocking coils located proximate to the distal end and designed to deliver electrical energy from the generator to cardiac tissue upon demand. Typically, such leads further include one or more sensors located proximally to the distal end, which detect the onset of episodes of arrhythmia.
Typically, a shocking coil is formed from one or more conductive wires that are helically wound about a continuous cylindrical section of the lead body. Such coils provide a large surface area for contacting the heart, thereby efficiently delivering energy to the heart when needed. However, one significant disadvantage seen with these prior art coils is that they have a tendency to buckle when the lead body is urged through blood vessels en route to the heart. This buckling stems from the fact that the vessels through which the lead must travel are sinuous, and the varying shape of the vessels provides along their length varying levels of resistance to further forward movement of the lead. As the physician urges the lead through the vessel, the shocking coil may buckle before it can navigate the required turns.
When a shocking coil buckles, it tends to become wider or increase in diameter in a localized area. This decreases the effectiveness of the coil in delivering energy to the heart and can cause localized scaring in adjacent tissue. In addition, such buckling of the coil leads to a local increase in the spacing of adjacent turns of the coil, thereby allowing detrimental tissue ingrowth into the coil. It would be beneficial, therefore, to provide a defibrillation lead having a shocking coil that is not susceptible to buckling during implantation.
The subject invention is directed to a new and useful implantable lead. The lead includes an elongated body having opposed proximal and distal end portions. At least one articulating defibrillation assembly is operatively associated with the distal end portion of the lead body for delivering electrical energy to cardiac tissue upon demand. A connector assembly is operatively associated with the proximal end portion of the lead body for interacting with an energy-generating device, such as an implantable defibrillator or pulse generator. A conductor assembly extends through the lead body to electrically connect the connector assembly to the defibrillation assembly.
The defibrillation assembly of the subject invention includes a plurality of axially spaced apart conductive hull assemblies and a helically wound shocking coil for delivering energy to tissue. The hull assemblies at least partially surround the elongated lead body. The shocking coil surrounds and is connected to at least one of the plurality of axially spaced apart hull assemblies, such that a series of annular void regions are defined between adjacent hull assemblies, the shocking coil and the lead body. In a preferred embodiment, the shocking coil is connected to each of the plurality of axially spaced apart hull assemblies.
The annular void regions enable the defibrillation assembly to articulate, while inhibiting buckling of the shocking coil as the lead traverses the venous system. In a preferred embodiment, each of the hull assemblies includes two radially inner axially spaced apart support hulls, which at least partially surround the lead body, and a radially outer primary hull, which at least partially surrounds, and is connected to, the support hulls.
The subject invention is also directed to a defibrillation assembly for an implantable lead. The defibrillation assembly includes a helically wound shocking coil for delivering energy to tissue, and a plurality of axially spaced apart stiffening members. The stiffening members are secured to the lead body at locations radially inward of the shocking coil, to allow the defibrillation assembly to articulate as the implantable lead traverses the venous system.
The subject invention is also directed to an implantable lead that includes shocking means for supplying electrical energy to tissue, means for providing alternating regions of stiffness and flexibility to the distal end portion of the lead body in an area occupied by the shocking means, and means for mechanically coupling the shocking means with the means for providing alternating regions of stiffness and flexibility, such that the shocking means is adapted to readily articulate at locations associated with the flexible regions of the distal end portion of the lead body.
These and other aspects of the implantable lead of the subject invention will become more readily apparent to those having ordinary skill in the art from the following detailed description of the invention taken in conjunction with the drawings.
So that those having ordinary skill in the art to which the present invention pertains will more readily understand how to make and use the implantable lead of the present invention, embodiments thereof will be described in detail hereinbelow with reference to the drawings, wherein:
Referring now to the drawings wherein like reference numerals identify similar structural aspects or features of the subject invention, there is illustrated in
Implantable lead 10 is adapted and configured for pacing/sensing and for defibrillation. Accordingly, lead 10 includes a pacing/sensing electrode 14 located at the distal end of elongated lead body 12, and a shocking coil 16 spaced proximally from the distal pacing/sensing electrode 14. The distal electrode 14 is used for pacing and as a mapping electrode, which senses electrical potentials. One or more additional electrodes may also be associated with the distal end portion of the lead body to facilitate bipolar pacing, including, for example, a ring electrode spaced proximal to the distal electrode 14. Other electrode configurations are also possible and well within the scope of the subject disclosure.
The shocking coil 16 is part of the articulating defibrillation assembly 30 of the subject invention and is designed to deliver electrical energy to cardiac tissue for cardioversion/defibrillation upon demand. It is envisioned that the shocking coil 16 can include one or more adjacently wound conductive elements, so that there is redundancy within the assembly in case an individual element should fail to function properly. Preferably, the lead body 12 is formed from a flexible, biocompatible, insulating material, such as, for example, implantable grade silicone or a similar material.
A connector assembly 18 is operatively associated with the proximal end portion of the elongated lead body 12. Connector assembly 18 is adapted and configured to interact with an energy-generating device, such as, for example, an implantable defibrillator or pulse generator/pacemaker (not shown). Connector assembly is bifurcated and thus it includes two connectors 24 and 26. Connector 24 is associated with the distal pacing electrode 14, while connector 26 is associated with the defibrillation assembly 30. In a preferred embodiment of the subject invention, connector 24 is an IS-1 type connector and connector 26 is a DF-1 type connector 26. Those skilled in the art will readily appreciate that other types of connectors can be employed, such as, for example, LV-1 type connectors and/or DF-4 type connectors, as well as others types known in the art, depending upon the configuration of the lead, for example, if the lead is configured fro unipolar or bipolar pacing and/or defibrillation.
Referring now to
While the conductor assembly is described as including several conductor coils 44, 46, there is no requirement that the conductors associated with the conductor assembly 20 are coiled. Specifically, in another preferred embodiment, the inner and outer conductors 44, 46 of conductor assembly 20 can be replaced by low resistance multi-standard wires or cables (DFT). In a particular embodiment, such DFT wires extend through multi-lumen tubing in order to connect the defibrillation assembly to an energy-generating device. Alternatively, such DFT wires may each be encased in respective insulation tubes.
As best seen in
With continuing reference to
In a preferred embodiment of the subject invention, conductive hull assemblies 31 a-31 d include respective cylindrical radially outer primary hulls 32 a-32 d, each of which substantially surrounds and is operatively associated with a pair of corresponding radially inner annular support hulls. For example, as seen in
In an embodiment of the subject invention, the radially inner annular support hulls of defibrillation assembly 30 are crimped or otherwise secured to the outer insulating tube 36 of conductor assembly 20 in axially spaced relationship. The support hulls are positioned in coaxial alignment with a corresponding primary hull. The primary hull is joined to the corresponding pair of support hulls by laser welding or by a similar joining technique known in the art.
The helically wound shocking coil 16 of defibrillation assembly 30 extends over or otherwise surrounds the axially spaced part primary hulls 32 a-32 d and the uncovered sections of the outer insulating tube 36 located therebetween. In one embodiment of the invention, the shocking coil 16 is electrically connected to, or otherwise attached or affixed to, each of the four primary hulls 32 a-32 d. Other embodiments, however, are also envisioned, in which shocking coil 16 is electrically connected to, or otherwise attached or affixed to, a single one of the primary hulls, or to several of the primary hulls, as desired for either electrical, mechanical, or other performance reasons, such as to provide redundancy in the case of a short.
As noted above, the hull assemblies 31 a-31 d form a conductive bridge between the radially outer conductor coil 46 of conductor assembly 20 and the shocking coil 16 of defibrillation assembly 30. More particularly, the radially outer conductor coil 46 is connected to one or both of the inner support hulls of one or more of the four hull assemblies, to form a conductive bridge. For example, as shown in
As best seen in
As illustrated in
As shown in
In the distal end portion of the lead body 12 occupied by the defibrillation assembly 30, the hull assemblies 31 a-31 d provide incremental areas of relative stiffness, while the annular void regions 34 a-34 c located between adjacent pairs of hull assemblies provide incremental regions of relative flexibility. The articulated shocking coil 16 is therefore configured to be urged or otherwise delivered through the somewhat sinuous coronary blood vessels during implantation, without buckling in a manner that increases the outer diameter of the coil in a localized area.
Moreover, as shown in
It is envisioned that the mechanical and/or physical properties of the defibrillation assembly 30 can be optimized or varied by the designer of the device. For example, in instances where increased stiffness is desired, the hull assemblies can be wider or placed closer together or a greater number of hull assemblies can be employed. Alternatively, in instances where the lead is required to be more flexible, the hull assemblies can be placed farther apart from one another or fewer hull assemblies may be employed, so long as the lead body maintains a requisite stiffness in the area occupied by the defibrillation assembly.
Referring now to
Other methods or structures for providing incremental areas of stiffness and flexibility are also envisioned and within the scope of the subject disclosure. For example, stiffening members other than or in addition to the cylindrical hull assemblies described herein may be employed at incremental locations underlying the shocking coil of the articulating defibrillation assembly. These features may be arranged coaxially with the shocking coil or they may be included at one or more off-axis locations. Such stiffening members could take the form of small cylinders or rings that me be formed from a conductive material or from a non-conductive material such as a ceramic or plastic.
Although the implantable defibrillation lead of the subject invention has been described with respect to preferred embodiments, those skilled in the art will readily appreciate that changes and modifications may be made thereto without departing from the spirit and scope of the subject invention as defined by the appended claims.
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|Citing Patent||Filing date||Publication date||Applicant||Title|
|US8406896||Jun 29, 2009||Mar 26, 2013||Boston Scientific Neuromodulation Corporation||Multi-element contact assemblies for electrical stimulation systems and systems and methods of making and using|
|U.S. Classification||607/122, 607/5, 607/4, 607/123, 607/125|
|May 25, 2005||AS||Assignment|
Owner name: OSCOR INC., FLORIDA
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:OSYPKA, THOMAS P.;REEL/FRAME:017093/0726
Effective date: 20050509
|Jun 7, 2012||FPAY||Fee payment|
Year of fee payment: 4
|Jun 7, 2016||FPAY||Fee payment|
Year of fee payment: 8